<![CDATA[The Laryngeal Mask Airway (LMA) is a supraglottic airway device introduced by Archie Brain in 1988 and has become one of the most important innovations in anesthetic practice. The development of second-generation LMAs has demonstrated significant improvements in safety, particularly through the addition of gastric drainage channels and higher oropharyngeal seal pressures. These innovations aim to reduce the risk of aspiration and enhance the effectiveness of positive pressure ventilation. In obstetric practice, especially elective cesarean section, second- generation LMAs such as the ProSeal LMA (PLMA) and Supreme LMA (SLMA) have shown promising outcomes in patients with low aspiration risk. Multiple studies report high first-attempt insertion success rates (98–100%), rapid insertion times, and adequate ventilation and oxygenation. Additionally, LMA use is associated with more stable hemodynamic responses and a low incidence of complications, including aspiration, hypoxia, and airway spasm. However, the endotracheal tube remains the gold standard for airway management in obstetric anesthesia. Second-generation LMAs are recommended as an alternative in selected situations, particularly in cases of unexpected difficult or failed intubation. Their use requires careful patient selection, adherence to preoperative fasting guidelines, and operator experience to minimize potential complications. In conclusion, second-generation LMAs are effective and relatively safe airway devices for elective cesarean section in selected patients and play a crucial role in difficult airway management algorithms in modern anesthetic practice]]>
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